17 Questions
What is the most common cause of massive hemoptysis in adults?
Bronchial arteries
What is the usual cause of acute serofibrinous pericarditis?
Viral infection
What is the result of mitral valve stenosis in adults?
Narrowing of the mitral valve
What is the usual cause of chronic pericarditis?
Mycobacterium tuberculosis or fungal infection
What is the site of bleeding in over 90% of massive hemoptysis cases in adults?
Bronchial arteries
What is the usual cause of acute purulent pericarditis?
Bacterial infection
What is the result of rheumatic carditis in adults?
Mitral valve stenosis
What is the category of carditis that includes inflammation of the heart muscle?
Myocarditis
What is the consequence of high pressure in the thoracic aorta?
Rupture of bronchial veins and capillaries
Which of the following is NOT a common cause of massive hemoptysis in children?
Bronchiectasis
What is the primary source of bleeding in over 90% of massive hemoptysis cases in adults?
Bronchial arteries
What is the most common cause of massive hemoptysis in adults?
Bronchogenic carcinoma
What is the purpose of the second goal of managing massive hemoptysis?
To prevent aspiration of blood into the non-bleeding lung
What is the consequence of the mitral valve narrowing?
Back pressure from the left atrium to develop in the thoracic aorta
What is the percentage of massive hemoptysis cases in adults that are caused by bleeding from the bronchial arteries?
Over 90%
What is the primary function of the bronchial arteries?
To supply arterial blood to the bronchial tubes
What is the percentage of cases of hemoptysis that are severe or massive?
Less than 5%
Study Notes
Causes of Hemoptysis
- In children, lower respiratory tract infection and foreign body aspiration are the most frequent causes of hemoptysis.
- In adults, the most common causes are acute bronchitis, bronchogenic carcinoma, bronchiectasis, and pneumonia.
Site of Bleeding
- In over 90% of massive hemoptysis cases in adults, the bronchial arteries are the site of bleeding.
Mitral Valve Stenosis
- Mitral valve stenosis is a narrowing of the mitral valve that separates the left atrium from the left ventricle.
- Mitral valve stenosis is an important cause of blood in the sputum.
- In adults, mitral valve stenosis is usually a complication of rheumatic carditis or bacterial endocarditis.
Carditis
- Carditis is inflammation of the heart.
- There are three categories of carditis: pericarditis, myocarditis, and endocarditis.
- Pericarditis is inflammation of the pericardium.
- Acute serofibrinous pericarditis is usually caused by a viral infection.
- Acute purulent pericarditis is usually caused by a bacterial infection (but not infection by Mycobacterium tuberculosis).
- TB Chronic pericarditis usually results from M.tuberculosis or fungal infection.
Bronchial Arteries
- The bronchial arteries supply arterial blood to the bronchial tubes, visceral pleura, bronchial lymph nodes, and esophagus.
- The two left bronchial arteries arise from the thoracic aorta.
- High pressure in the thoracic aorta can rupture bronchial veins and capillaries causing hemoptysis.
- The right bronchial artery arises from the third posterior intercostal artery.
Clinical Management
- In most cases, hemoptysis is a self-limiting condition and does not require hospital admission.
- Less than 5% of cases are severe or massive, representing a life-threatening condition.
- The three main goals for management of massive hemoptysis are:
- Stop the bleeding.
- Prevent aspiration of blood into the non-bleeding lung.
- Identify and treat the underlying cause of the hemoptysis.
Test your knowledge on the causes of hemoptysis in children and adults, including lower respiratory tract infections, foreign body aspiration, and bronchial artery bleeding. Learn about the diagnostic criteria and common causes of massive hemoptysis.
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